There is actually some sort of weird symmetry on the map. A band of yellow down the middle with orange on either side and Texas and Wisconsin opposing each other in red. It would interesting to see this map’s correlation to other factors.

This goes to show how inconsistent this reform is. Why bother go through all the trouble of creating and passing a new law, if no one is going to abide it? Either there is a lack of enforcement from the government’s part, or states simply know how unlawful this reform is, and of course they don’t want to adopt it.

What incentive was there for states to make any adjustments prior to (i) the SCt ruling last summer, and (ii) release of the HHS guidelines (which just happened on 2/20/13)? Further, note that it’s not necessarily a bright-line definition of “essential.” Rather, there’s room for flexibility, state-to-state.

“It is important to note that in 2014 some states may have broader requirements for Essential Health Benefits than others because each state has some influence on the details within each Essential Health Benefit category. The Affordable Care Act requires that Essential Health Benefits be equivalent to the coverage offered by a “typical employer plan” within a state.”

I am not surprised by this, our health care system is a complex network, with some practices top of the line while others are a hot mess. Given this variance, I am not surprised they don’t meet the ACA standards.